Anthony Gay is severely mentally ill. And like many Americans who suffer from severe mental illness and who commit a crime, he was placed in solitary confinement after his conviction, rather than in a mental hospital where he could have received treatment for his schizophrenia. 

Isolated in a 6-by-10 foot cell 24 hours a day, seven days a week, he spiraled into paranoia and began engaging in shocking self-mutilation. Gay stabbed himself in the eye with a razor blade. He cut off pieces of his own flesh and ate them. He cut out one of his own testicles and left it hanging on a cell door. He then stitched his scrotum closed with a zipper. 

Instead of being transferred to a hospital, or even the prison’s mental health unit, Gay had time added on to his sentence, all of it in solitary. His seven-year sentence eventually became 97 years. What was his crime? He was convicted in 1993 of stealing a $1 bill and a hat. Gay was scheduled for release in 2093 until a judge finally recognized that the system had failed him. He was eventually released from prison and sent to a hospital, but not until he had spent 22 years in solitary.

Solitary confinement is the practice of isolating a prisoner from all human contact for an extended period of time. It is often used as a form of punishment or to control behavior, but it can have serious negative effects on mental health. Most countries around the world limit the time that a prisoner can spend in solitary to 15 days. The United States doesn’t. 

There are scores of prisoners across the U.S. who have been in solitary for years and, in some cases, decades. It should be clear to everybody — the courts, the states, and the Federal Bureau of Prisons — that solitary only worsens already bad situations. It shouldn’t be in use.

We already knew that, of course. Solitary confinement as a punishment was invented in 1829 at Eastern State Penitentiary in Philadelphia. The idea was to build an imposing, neo-Gothic, escape-proof maximum-security penitentiary where every prisoner was kept in solitary confinement. Each tiny cell had nothing but a bed, a chair, a small table, a chamber pot and a Bible. 

The idea was that if the prisoner had nothing to do with his time other than to read the Bible, he would be a good, law-abiding Christian man by the time he was released. Instead, everybody went insane.

Eastern State Penitentiary, a former prison in Philadelphia. (Carol M. Highsmith Archive, Library of Congress, Prints and Photographs Division)

There is a growing body of research that shows that solitary confinement as it is used today can cause a variety of severe psychological problems, including anxiety, depression, paranoia, hallucinations and suicidal thoughts. These problems can be so severe that they can lead to long-term disability or even death.

A true account of the number of mentally-ill prisoners held in solitary confinement in the United States could fill a library. But the stories are generally consistent. The longer a person is held in solitary, the worse his mental state becomes. The younger a person is when he begins a sentence in solitary, the worse his mental state becomes. And the situation is usually hopeless when a person who is already mentally ill is placed in solitary whatever his age. It’s no wonder that the United Nations has declared the U.S. practice of solitary confinement to be a form of torture: 

The ruins of a prison corridor in the Eastern State Penitentiary in Philadelphia. (Adithyavr, Wikimedia Commons, CC BY-SA 4.0 ) 

  • Cesar Villa, a prisoner in the solitary confinement unit at Pelican Bay State Prison in California wrote in his 12th year in solitary, “Nothing can really prepare you for entering the SHU (Segregated Housing Unit). It’s a world unto itself where cold, quiet and emptiness come together, seeping into your bones, then eventually the mind. The first week I told myself: It isn’t that bad, I could do this. The second week, I stood outside in my underwear shivering as I was pelted with hail and rain. By the third week, I found myself squatting in a corner of the yard, filing fingernails down over coarse concrete walls. My sense of human decency dissipated with each day. At the end of the first year, my feet and hands began to split open from the cold. I bled over my clothes, my food, between my sheets. Band-aids were not allowed, even confiscated when found. My sense of normalcy began to wane…Though I didn’t realize it at the time — looking back now — the unraveling must’ve begun then. My psyche had changed — I would never be the same.”

Pelican Bay State Prison in California. (Jelson25, Wikimedia Commons, CC BY 3.0)

  • Thomas Silverstein, who spent 28 years in solitary in the U.S. Penitentiary in Atlanta before dying there, wrote, “The cell was so small that I could stand in one place and touch both walls simultaneously. The ceiling was so low that I could reach up and touch the hot light fixture. My bed took up the length of the cell, and there was no other furniture at all…The walls were solid steel and painted all white…Shortly after I arrived, the prison staff began construction, adding more bars and other security measures to the cell while I was within it…It is hard to describe the horror I experienced during this construction process. As they built new walls around me it felt like I was being buried alive…Due to the unchanging bright artificial lights and not having a wristwatch or clock, I couldn’t tell if it was day or night. Frequently, I would fall asleep and when I woke up I would not know if I had slept for five minutes or five hours, and would have no idea of what day or time of day it was…I now know that I was housed there for about four years, but I would have believed it was a decade if that is what I was told. It seemed eternal and endless and immeasurable.
  • William Blake called his 25 years in solitary “a sentence worse than death,” and added, “I’ve experienced times so difficult and felt boredom and loneliness to such a degree that it seemed to be a physical thing inside—so thick it felt like it was choking me, trying to squeeze the sanity from my mind, the spirit from my soul, and the life from my body. I’ve seen and felt hope becoming like a foggy ephemeral thing, hard to get a hold of, even harder to keep a hold of as the years and then decades disappeared while I stayed trapped in the emptiness of the SHU world. I’ve seen minds slipping down the slope of sanity, descending into insanity, and I’ve been terrified that I would end up like the guys around me that have cracked and become nuts. It’s a sad thing to watch a human being go insane before your eyes because he can’t handle the pressure that the box exerts on the mind, but it is sadder still to see the spirit shaken from a soul. And it is more disastrous. Sometimes the prison guards find them hanging and blue; sometimes their necks get broken when they jump from their bed, the sheet tied around the neck that’s also wrapped around the grate covering the light in the ceiling snapping taut with a pop. I’ve seen the spirit leaving men in SHU and have witnessed the results.”
  • In 2016, Kalief Browder killed himself after spending three years in solitary confinement at Rikers Island jail in New York City. Browder was 16 years old when he was arrested for allegedly stealing a backpack. He was never charged with a crime, but he was held in solitary while he awaited trial. Browder’s family said that he suffered from severe psychological problems while in solitary confinement, including anxiety, depression and paranoia.

Rikers Island in New York’s East River. (Doc Searls, Flickr, CC BY 2.0)

  • And although less common, women also are held in solitary. Sarah Jo Pender spent five years in the Indiana Women’s Prison solitary confinement unit after a nonviolent prison escape. She wrote, “Women who enter sane will become so depressed that they shut down or hurt themselves. I watched a woman claw chunks of flesh from her cheeks and nose and write on the window with her blood. My neighbor bashed her head against the concrete until officers dragged her to a padded cell…Right across from my cell, a woman slit her own throat with a razor and was wheeled out on a gurney. Two others tried to asphyxiate themselves with bras and shoestrings. Now no one has shoestrings and we shuffle around in floppy tennis shoes with loose tongues .… Another woman cut her wrists using the metal band around a pencil eraser. Now, all our pencils are stripped naked. It is always the poor prisoner porter who is forced to clean up the blood puddles and shit smears left behind when someone’s mind spirals down the rabbit hole.”

The research on the effects of solitary confinement on mental health is clear: Nothing good comes of solitary. It causes or exacerbates serious psychological problems and frequently leads to long-term disability or even death. The United Nations condemns it and much of the rest of the world won’t practice it in their own prisons. It is a living example of the failure of the both the U.S. prison system and the U.S. mental healthcare system. Repairing those will take a great deal of time, money, and effort. But the very first step must be to end solitary confinement.

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